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NPI Code Detail

MEDICARE: BRANDON KYLE KILLIEBREW

MEDICARE: BRANDON KYLE KILLIEBREW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1374U00000XHome Health AideNAMO

General Provider Information

NPI Number : 1982553004
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON KYLE KILLIEBREW
Provider Business Mailing Address
First Line : 1152 SHACKELFORD RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63031-4369
Country : US
Telephone Number : 314-388-1530
Fax Number : 314-388-1550
Provider Business Practice Location Address
First Line : 1152 SHACKELFORD RD
Second Line :
City : FLORISSANT
State : MO
Zip : 63031-4369
Country : US
Telephone Number : 314-388-1530
Fax Number : 314-388-1550
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/22/2026
Last Update Date : 01/22/2026

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Directions to “ BRANDON KYLE KILLIEBREW ” Practice Location

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